Enhanced Care for Older People (EnCOP)

Enhanced Care for Older People Workforce Competency Framework - Developing a valued workforce across health and social care to meet the needs of older people

[Alasdair MacLullich @A_MacLullich]

Medical student experience of an encounter with a patient with delirium -

"Mrs. P was 83. She was in a bay of 4 patients on a medical ward. Two of them were noisy - one was calling out repeatedly, another had a loud TV.

Mrs. P was quiet. Eyes open, staring at the ceiling. Looked unhappy and puzzled. Not eating the lunch tray in front of her. Not pressing her call bell. Not moving much.

In a busy ward, quiet patients are 'settled' patients. Nobody seemed worried about Mrs. P.

I was taking histories as part of my clinical attachment. I sat down next to her and said hello and introduced myself. She looked at me briefly but didn't answer. She looked away. I asked her name. She did not answer. I asked her again and she gave her name. I asked where she was. She looked surprised by the question then said, 'at home'.

She had no idea she was in hospital.

I mentioned this to the ward doctor. He came and assessed her. She was profoundly inattentive, disoriented in time and place, and had been like this for at least two days based on the nursing observations - which had documented 'settled' and 'comfortable' because she wasn't causing any problems, though two entries also mentioned 'confused' ? baseline - though no additional mental status assessments had been done.

She had pneumonia and constipation that were already being treated, but nobody had formally recognised that her quietness was delirium. Hypoactive delirium. The subtype where patients don't shout, don't climb out of bed, don't pull out their lines. They just... go quiet.

And going quiet, in a hospital, can make you less visible.

Hypoactive delirium is more common than the hyperactive form, and it carries a worse prognosis. Patients with hypoactive delirium have higher mortality rates, and longer hospital stays. Yet it's detected even less often, because it doesn't trigger alarms. It doesn't create workload. It doesn't disrupt the ward.

The noisiest patients get the most attention but the quietest patients may be sicker.

Since that day, I make a point of doing a delirium assessment on the quiet ones."

[Just a care home girl @Justacarehomeg1]

#Grief affects #carehome staff. The #loss of characters & #relationships through #death. The void of serving residents & their family that have mattered to you for so long.
When someone dies, take a moment. #Pause, remember them, thank them, acknowledge your part in their life

[Parkinson's UK @ParkinsonsUK]

It’s deeply concerning to hear that someone with Parkinson’s has been prevented from boarding a flight because of their condition. @MarkIMardell & James Jopling, our Scotland Country Director, spoke to @BBCr4today to raise awareness. Listen from 2:32:29: https://t.co/X0zf9moiBx

[DDOT/The Alexandra Centre @AlexandraCentre]

We can hear you thinking what the Elf! But there’s no time like the present….to announce DDOT’s #NightWearBeforeChristmas appeal. We’re asking you all, if you can to donate again this year for our older patients at SRH and STDH. All details are below 👇 👇 👇

[British Geriatrics Society @GeriSoc]

We welcone @RCPhysicians new position statement on palliative and end of life care. We support the call for a public campaign, improved education, and a national strategy.

Most people dying each year are older people, it is vital their needs are met.

https://t.co/4fJg8brery

[British Geriatrics Society @GeriSoc]

@RCPhysicians The needs of older people are different to those dying at a younger age. Their care is mainly provided by the generalist workforce not palliative care specialists. The wider workforce needs to be upskilled, and the role of other specialties recognised.

https://t.co/p3f0ggwAIu

[North East and North Cumbria NHS @NENC_NHS]

📢 Don’t miss this webinar about collaborating to support older people living with dementia to live independently

📅20 May | ⏰ 10am - 12pm | 💻 Microsoft Teams
To book, email [email protected]

Learn more https://t.co/ywTZnDVRjx

[Enhanced Care for Older People (EnCOP) @EnCOP_Workforce]

@TheKingsFund @mancunianmedic @swoolnough @GSK Well done Search Newcastle 👏👏👏👏👏

[The King's Fund @TheKingsFund]

Yesterday afternoon, @swoolnough met the winners of the 2025 @GSK IMPACT Awards. They’re in the building taking part in a three-day training and development programme that’s part of the winners’ package. Find out more: https://t.co/66OZn2qSdL

[James Adams @jaa_adams]

New report @GeriSoc 👇
Not enough nurses and AHPs working in older peoples care.
We don’t just need the numbers, we need an mdt equipped with key knowledge and skills in managing frailty too. It’s time we prioritised older peoples workforce planning @NHSE_WTE

[Enhanced Care for Older People (EnCOP) @EnCOP_Workforce]

https://t.co/u8LZr2rKoV

[Vicky Johnston @greyhoundvicky]

Swimming upstream: Working as a Frailty Physiotherapist in a Primary Care Network https://t.co/9KSZLsxUmx

[Enhanced Care for Older People (EnCOP) @EnCOP_Workforce]

@DrEilidhMaria What’s your definition of a senior Elidh ?

[Enhanced Care for Older People (EnCOP) @EnCOP_Workforce]

https://t.co/YJRvrwZOYH

[Enhanced Care for Older People (EnCOP) @EnCOP_Workforce]

https://t.co/aw1AtfYdBE

[Enhanced Care for Older People (EnCOP) @EnCOP_Workforce]

@20bexie09 Cuteness overload 🥰

[Enhanced Care for Older People (EnCOP) @EnCOP_Workforce]

https://t.co/OnXOKr0oZZ

[Enhanced Care for Older People (EnCOP) @EnCOP_Workforce]

https://t.co/C56EuiWWSG

[Shaun Lintern @ShaunLintern]

People who are racist to NHS staff “can and should” be turned away from care @wesstreeting has told @PA

“I was appalled by reports of violence directed towards Filipino nurses in Sunderland...their attackers bring shame on our flag and shame on our country.”

[Professor Chris Whitty @CMO_England]

I am immensely proud that the NHS I work in is one of the most multi-ethnic and diverse organisations in the world.

NHS colleagues and emergency workers from many countries and faiths work around the clock to serve every UK community. You have my utmost appreciation and respect.